Diaphragmatic hernia is a congenital defect in which an opening is present in the diaphragm (the partition separating the chest and abdominal cavities) at birth. This abnormal opening allows some of the organs typically found in the abdomen to move into the chest cavity.
In infants born with diaphragmatic hernia, organs including the spleen, stomach, small intestine, part of the liver, and the kidney may be found in the chest cavity rather than in the abdomen. The lungs may also be abnormally developed.
Diaphragmatic hernia is a serious condition with many potential complications and side effects. However, the developments of technology and procedures have improved the survival rate to approximately 67%.
Treatment includes the following:
Surgery to repair the defect and move the organs into the abdomen is performed after the infant has been stabilized. This period of stabilization may take 48 hours or more. Surgery involves either sewing the edges of the diaphragm together, or if the hole is too large, using an artificial patch to fully close the hole. Fetal surgery may be offered at some institutions for select patients.
Aggressive respiratory support, including
intubation with mechanical ventilation
, is often needed. Different ventilator strategies may be used. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass, may be necessary to stabilize the infant.